Treatment Type Is Associated with Population Hand Preferences in Patients with Unilateral Coronal Synostosis: Implications for Functional Cerebral Lateralization.

BACKGROUND Left-handedness is a highly conserved marker of cerebral functional laterality in the human population; elevated rates of left-handedness have been documented in patients with unilateral coronal synostosis treated with fronto-orbital advancement. The purpose of this study was to determine whether the prevalence of left-handedness in patients with nonsyndromic unilateral coronal synostosis is related to treatment. METHODS The incidence of left-handedness was compared among three groups: patients who were previously treated for unilateral coronal synostosis with endoscopic suturectomy and postoperative helmet therapy (group I); patients with unilateral coronal synostosis managed with fronto-orbital advancement (group II); and healthy, unaffected controls (group III). RESULTS Group I was composed of 19 patients; the side of synostosis was equally distributed (nine right and 10 left), and female gender was more common (n = 13). Mean age at endoscopic suturectomy and helmet therapy was 85.3 days, and the determination of handedness was performed at a mean age of 89.3 months. The rate of left-handedness in group I was 5.3 percent, not significantly different from that of the controls (group III) (11.5 percent) (p = 0.69) but significantly less than that observed in the fronto-orbital advancement patients (group II) (30.2 percent) (p = 0.023). CONCLUSIONS Patients who underwent endoscopic suturectomy and helmet therapy for nonsyndromic unilateral coronal synostosis and healthy controls demonstrated functional cerebral lateralization with respect to handedness that differed from patients who underwent fronto-orbital advancement. The reason may be related to the type of procedure, secondary effects of general anesthesia, or age at which the procedure was performed.